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Abstract
Objective To evaluate radiographic knee osteoarthritis (OA) progression, development of knee OA, patient-reported outcomes and knee muscle strength at 10-year follow-up after arthroscopic partial meniscectomy (APM) or exercise therapy for degenerative meniscal tears.
Methods Randomised controlled trial including 140 participants, with a degenerative meniscal tear and no or minimal radiographic OA changes. Participants were randomised to either APM or 12 weeks of exercise therapy (1:1 ratio). The primary outcome was knee OA progression assessed by the Osteoarthritis Research Society International (OARSI) atlas sum score (sum of medial and lateral compartment joint space narrowing and osteophyte score). Secondary outcomes included incidence of radiographic and symptomatic knee OA, patient-reported pain and knee function and isokinetic knee muscle strength.
Results The adjusted mean difference in change in the OARSI sum score was 0.39 (95% CI −0.19 to 0.97), with more progression in the APM group. The incidence of radiographic knee OA was 23% in the APM group and 20% in the exercise group (adjusted risk difference 3% (95% CI −13% to 19%)). No clinically relevant differences were found in patient-reported outcomes or isokinetic knee muscle strength.
Conclusion No differences in radiographic knee OA progression and comparable rates of knee OA development were observed 10 years following APM and exercise therapy for degenerative meniscal tears. Both treatments were associated with improved patient-reported pain and knee function.
Trial registration number NCT01002794.
- arthroscopy
- exercise
Data availability statement
Data are available on reasonable request.
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Data availability statement
Data are available on reasonable request.
Footnotes
X @ewa_roos, @dr_englund, @larsengebretsen
Contributors BB, EMR, ME and MAR conceived and designed the study. BB, NJK, LE and MAR contributed to the acquisition of data. All authors contributed to the analysis or interpretation of data. BB wrote the initial draft. All authors revised the draft critically for important intellectual content and approved the final version. BB acts as guarantor and takes responsibility for the integrity of the data and the accuracy of the data analysis. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.
Funding This study was funded by grants from the South-Eastern Norway Regional Health Authority (grant number 2018023); Sophies Minde Ortopedi; Swedish Rheumatism Association; Swedish Research Council; Governmental Funding of Clinical Research within National Health Service (ALF); Foundation for Support to People with Movement Disability in Skåne; Region of Southern Denmark and the Danish Rheumatism Association.
Disclaimer The funders had no role in the design and conduct of the study; collection, analysis and interpretation of data; preparation, review or approval of the manuscript or decision to submit the manuscript for publication.
Competing interests BB reports grants from the South-Eastern Norway Regional Health Authority, during the conduct of this study. EMR is the copyright holder of Knee injury and Osteoarthritis Outcome Score (KOOS) and several other patient-reported outcome measures, and co-founder of the Good Life with Osteoarthritis in Denmark (GLA:D), a not-for-profit initiative to implement clinical guidelines in primary care hosted by University of Southern Denmark. ME reports consultancy for Grünenthal Sweden AB. MAR is the co-founder of the AktivA (www.aktivmedartrose.no) in Norway, a not-for-profit initiative to implement evidence-based guidelines hosted by the Oslo University Hospital. All other authors declare no competing interests.
Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the 'Methods' section for further details.
Provenance and peer review Not commissioned; externally peer reviewed.
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